• The Journal of the Institute of Internet, Broadcasting and Communication
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• v.13 no.3
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• pp.79-86
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• 2013

Departments of family medicine at some general hospitals find it difficult to hold regular conferences because they have a small number of faculty members. The recent technological development of videoconferencing has made it possible for these small departments to regularly participate in the conferences held by departments with a larger number of faculty members. The objective of this study was to show the level of satisfaction with and acceptance of our videoconferencing system. One presenting site and four receiving sites participated in the videoconferences, which were held every Monday for three weeks. There were no significant differences in the levels of satisfaction with the videoconferences between faculty at the presenting site and faculty at the receiving sites. In contrast, residents at the receiving sites rated most items related to satisfaction with the videoconferences lower than residents at the presenting site. There were no changes between the pre-test and post-test scores of residents both at the presenting site and at the receiving sites. Despite its limitations, the advantages of joint-videoconferencing among several departments of family medicine were comfort level, time-saving, increasing the number of participants, promoting discussion, and provoking thought.

• Progress in Medical Physics
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• v.3 no.2
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• pp.13-22
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• 1992

Traditionally. the wedge factor of universal wedge is regarded as constant for small depth. Recently. some investigators have reported the beam hardening effect from wedged beam even in small depth. suggesting that the wedge factors are depth dependent values. Here authors performed the study to determine the proper depth of measurement for wedge factor. In this study. we have measured the wedge factors (nominal wedge angles 15, 30, 45, and 60) not only for depth maximum. but also for each depth, for several energies (4MV, 6MV, 10MV, and 15MV) of various machines (Varian, Siemens, Mitsubishi). And we have analysed the treatment depth of 614 patients who had been treated with wedged field at our hospitals to determine of the proper depth of the measurement point for wedge factor. More than 60% of the patients are treated at the depth of 8cm$\pm$2.5cm with the wedged field for various machines. energies, and wedge angles. The results of the wedge factor measurements show that the systemic error of average 2% (maximum 4%) might be inherently originated for the patients who had been treated with wedged field if we adapt the depth maximum as the wedge factor determination depth due to beam hardening effect. But we could achieve average error less than 0.5% (maximum within 1.7%) if we use 8cm for wedge factor measurement point We conclude that the measurement depth point for wedge factor should be 8cm in order to deliver more accurate dose to target for Korean patients. instead of depth maximum.

• Advances in pediatric surgery
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• v.12 no.1
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• pp.70-85
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• 2006

A nationwide survey on necrotizing enterocolitis (NEC) was undertaken among members of the Korean Association of Pediatric Surgeons. The members were required to complete a questionnaire and the case registration form for each patient during the three-year period from July 2001 to June 2004. Eighty one patients were included in the questionnaire, but only 71 patients were registered from 22 members in 16 hospitals. At the same time survey on focal intestinal perforation (FIP) was undertaken and 17 patients were registered from 11 members in 10 hospitals. Total 19,041 newborns were admitted to neonatal intensive care unit during the study period. Eighty one patients (17.27 %) were underwent surgery among 469 babies who were managed under the impression of NEC. The male to female ratio was 2.1:1. The premature were 60.6 %. The most common site of involvement was ileum. Overall and operation survival of NEC were 72 % and 79 %, respectively. The survival was lower in smaller babies, multiple segments involvement and involvement of both the small and large intestine. But there was no difference in survival according to sex or prematurity. The FIP showed very similarity with NEC in terms of incidence, and the age of diagnosis and operation. But the survival was much better and 100 %. The results showed the clinical characteristics of NEC and the trend of management in NEC in Korea. In the future we hope we can discuss about this topic in prospective manner.

• Korea Journal of Hospital Management
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• v.11 no.1
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• pp.1-30
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• 2006

According to the available data, in these days, the number of medical accidents and disputes have significantly increased since 1990 in Korea. From this aspect, a variety of approaches and efforts to solve these problems is needed before it is too late. This study intended to identify the thoughts of patients who are directly connected with medical accidents and disputes and then to consider reasonable settlement methods of the increasing disputes. For achieving the purpose of this study, the self-administerd questionnaire was conducted with 450 out-patients who visited three university hospitals, five small and medium-sized hospitals, and ten clinics in Seoul from June 13 to 17, 2005. Incomplete questionnaires were omitted and 410 respondents(91%) were included for the analysis of this study. Each section of the survey was composed of six categories such as the recognition of malpractice, a compensation system about no-fault medical accidents, the recognition of the judgement of medical accidents in court, reasonable settlement of medical accidents, reasons of lawsuit, and the need of the medical dispute settlement organization. The major results of this study were as follows. First, more than half of the respondents, 51.9 percent, worry about malpractice. And many respondents think malpractice causes their symptoms to persist or become worse, and also some respondents think that the doctor's prescription changed too frequently. Second, as for a compensation system about no-fault medical accident, 55.7 percent of the respondents insist that a proper compensation for suffering patients or their families should be provided. And also as for the responsibility of compensation, respondents think joint compensation of both the medical institution and the government is needed foremost, followed by the medical insurance company and finally by the medical institution. The government as well as the related institutions should take responsibility for malpractice accidents for which the doctor is not responsible. Third, as for the acknowledgment of medical accident judgements by the court, 32.8 percent of respondents think that it is best to compromise with a medical institution, followed by lawsuit(26.2%), the assistance of civil organization(23.2%), and a powerful physical protest(7.6%). Fourth, as for the lawsuit of medical accidents, 62.9 percent of respondents think that patients and their families would be in a disadvantageous position in relation to medical institutions and doctors mentioning the lack of professional medical and lawful knowledge, experience and know-how as the reason. So many people have given up appeals owing to the difficulties involved in defending themselves through evidence. Fifth, about a half share of the respondents indicated that the medical institution's neglect of the responsibility of medical accidents is one of the most important reasons of lawsuit. And next respondents mentioned the lack of the medical dispute settlement organization and a general distrust of medical institutions and doctors. Sixth, a majority of respondents consented to the introduction of the need of the medical dispute settlement organization, And about a half of the respondents mentioned a readiness to accept the mediation of the organization, but the rest did not express a clear opinion. It seems that conflict among the parties concerned have existed in relation to the medical dispute settlement organization and related legislation for many years. But as this study has shown, the needs of the medical dispute settlement organization is in desperate demand. Therefore, more negotiation efforts from all interest groups should be considered for the birth of the medical dispute settlement organization and related legislation.

• Advances in pediatric surgery
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• v.16 no.1
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• pp.1-10
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• 2010

The members of the Korean Association of Pediatric Surgeons conducted a retrospective study of two hundred and twenty-two cases of intestinal atresia for the period from January 1, 2007 to December 31, 2009. Seventeen hospitals were involved. There were 76 duodenal, 65 jejunal, and 81 ileal atresias (3 colonic). The male to female ratio was 0.85:1 in DA and 1.34:1 in JIA. Ninety-four patients(43.3 %) were premature babies (DA 40.3 %, JA 64.6 %, IA 28.8 %), and 70 babies (32.0 %) had low birth weight (DA 38.7 %, JA 44.4 %, IA 16.0 %). Antenatal diagnosis was made in 153 cases (68.9 %). However, 27 infants (17.6 %) with antenatal diagnosis were transferred to the pediatric surgeon's hospitals after delivery. Maternal polyhydramnios was observed in 81 cases (36.59 %) and most frequent with proximal obstruction. In forty-four cases (19.8 %), only simple abdominal film was taken for diagnostic study. The associated malformations were more frequently observed in DA - 61.8 % in DA and 22.6 % in JIA. Meconium peritonitis, small bowel volvulus and intussusception were more frequently associated with ileal atresia. The overall mortality rate was 3.6 %. (Abbreviations: DA;duodenal atersia, JA;jejunal atresia, JIA;jejunoileal atresia, IA;ileal atrsia).

• Journal of Korean Academy of Nursing
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• v.3 no.1
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• pp.41-51
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• 1972

In this article, the writer attempted to study the followings: (1) mother's knowledge of milk feeding (including method of sterilization, formula and feeding) (2) reasons of artificial feeding (3) how much mothers are concerned about their artificial feeding infants (4) condition of growth and development of artificial feeding infants. As the object of study, 96 mothers with artificial feeding infants, who had consulted dep't of pediatrics of two Hospitals in Seoul (Korea Hospital and Med. College Woo Suk Hospital, Korea Uni.) and well baby clinic of the two Health Centers (Sung Dong and Dongdaemoon), were randomly sampled. The data were treated by the statistic method of chi-square and percentage, and come to the following conclusion. 1. Knowledge of milk feeding Sterilization: 70 percentages of mothers know about the milk sterilization (including bottle, nipple and instrument), but 55 percentages of them do not know the nipple sterilization correctly. Formula: 69 percentages of mothers follow the indicator or in accordance with doctor's directions, but 31 percentages do at their option by reasons that the baby often coughs up the milk, the baby is too small, the baby often has digestive troubles, or the baby grow fleshy heavily etc, except family economic problems. Feeding: only half of mothers know the correct feeding method, especially they do not know how to determine the heat degree of milk and how to bubble up the baby correctly. They just do feeding according to the accepted usages. 2. Reasons of artificial feeding Of the reasons of artificial feeding, 18 percentages were caused by infants and 82 percentages by mothers. Most of the reasons are mainly due to the lack of breast milk and sufficient supply of nourishments rather than mother's deficiency or mother's abnormality. 3. Mother's concern for artificial feeding infants Mothers who are sharply concerned for their artificial feeding baby's growth and development: 63%, mothers who made the baby (artificial feeding infant) routine vaccinated: 81%, mothers who ear anxious about the baby's future personality forming : 68%, mothers who care about the baby's condition of nourishment; 60%, mothers who are anxious about tile selection of baby's food; 54%. 4. The growth and development of artificial feeding infants compared with Korean average infants. The artificial feeding infants are above the Korean average infants in stature by 1.21 centimeters and in weight by 0.3 kilograms. Conclusion: It has been said that there is no better food for infant than the breast milk. However, the artificial feeding has been used for the supplement of nourishments and as substitute food for the breast milk. And this artificial feeding could give the married women the chance to act in society and more opportunity to develop themselves and to work for others at home and other fields. Considering these advantages, artificial feeding should not be exclusive, but preferably should be more improved and inquired positively. And even in artificial feeding, what is most important is that mothers should recognize the requirement and need of artificial feeding clearly and correctly, and they should be accustomed to the correct knowledge and skills of artificial feeding in order to practice it appropriately. In some degree, they should be properly trained in school education process.

• Health Policy and Management
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• v.7 no.1
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• pp.100-124
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• 1997

In order to suggest the strategies for participation in the PPS(Prospective Payment System), analyses were performed based on variations in utilization pattern and changes in revenues of hospitals in 10 selected KDRGs. The data was collected from the claims data of a tertiary hospital in Kyunggido from September 1, 1995 to August 31, 1996. The studies consisted of 1, 718 inpatients diagnosed for lens procedures, tonsilectomy &/or adenoidectomy, appendectomy with complicated principal diagnosis, Cesarean section, or vaginal delivery without any complications. The resources used in each KDRG were measured including average length of stay, total charges, number of orders, intensity of medical services, frequencies of medical services, the rate of non-reimbursable charges, and the rate of non-reimbursable orders. Then, the changes in hopital revenues due to the composition of medical fee schedules under the PPS were estimated as follows: 1) The variations in average lenght of stay, total charges, number of orders, the intensity of medical services, the frequency of medical services, the rate of non-reimbursable charges, and the rate of non-reimbursable orders among the 10 KDRGs were comparatively small. 2) The average lenght of stay was the longest(6.0 days) for appendectomy with complicated principal diagnosis, while it was the shortest(2.1 days) for two vaginal deliveries. Statistically differences existed in the average length of stay among physicians and among the dates of admission in several KDRGs. 3) The total charges were the highest for lens procedures(1, 716, 000 won), while the lowest charges were for two vaginal deliveries(558, 000 won). Statistically differences in the total charges were found among physicians in several KDRGs: however, there were no differences with the dates of admission. 4) The number of orders was the greatest(155) for appendectomy with complicated principal diagnosis, while it was the smallest(75) for the two vaginal deliveries. Statistical differences in the number of orders did not exist among physicians in the KDRGs. 5) Significant differences were found in the intensity of medical services, and in the frequency of medical services among physicians in the KDRGs. 6) The rate of non-reimbursable charges for each KDRG was not related to the rate of non-reimbursable orders. The rate of non-reimbursable orders was the highest(36.0%) for lens procedures, while the lowest rate(11.6%) was for appendectomy with complicated principal diagnosis. The rate of non-reimbursable charges was the highest(39.4-39.7%) for vaginal deliveries, while the lowest rate(13.1%) was for tonsillectomy &/or adenoidectomy(<17 ages). 7) If the physician's practicing style were not change under the PPS, the hospital revenuses could be increased by 10%, and the portion of patient payment could be decreased by 1.4-22.4%. However, the non-reimbursable charges for showed little change between two reimbursement systems. Based upon the above findings, this hospital could be eligible for participation in the PPS(Prospective Payment Systm). However, the process of diagnosis and treatment should be standardized, inentifying methods to reduce cost and to assure quality of medical care. Furthermore, consideration should be given to finding ways to increase patient volume.

• Journal of Korean Academy of Nursing Administration
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• v.2 no.1
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• pp.57-72
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• 1996

Provision of better nursing care to patients is a difficult but important task. The first problem for nursing quality improvement is development of evaluation tool for the quality of nursing care. This study tries to develop a patient care tool for patients with chronic renal failure. This study as a procedural evaluation of patient care, tries to show what, how, at what order to provide care to patients with chronic renal failure. This study is divided into process of development of tool, its reliability and validity. Among process of development of tool is focal group, small expert group and expert evaluation group. To develop approprieteness of tool, nurses working is four major hospitals is Seoul were selected. To evaluate the credibility of subjects, 19 patient who were hospitalized and discharged within 3 months were selected. The period for collecting data for reliability and valiability evaluation was between Sept. 20 to Oct. 18, 1995. The development process of this study is as follows ; 1. Make preliminary list of the tool by focal group consisting of 8 clinical nurses. 2. Modify and add preliminary list by 4 expert nursing panel. 3. Calculate content validity of the tool by 23 nursing expert panel of judge. 4. Verity relability and validity of the tool. 5. Finalize an evaluation tool for the quality of nursing care in chronic renal failure patient. The result of this study were as follows ; 1. Development of evaluation tool for the quality of nursing care in chronic renal failure. 1) The evaluation of this study was developed 5 standards, 28 criteria. and 130 indicators 2) Nursing care evaluation scores for chronic renal failure patients were average 68.8. 2. Verity reliability and validity of the tool. 1) 5 standards were divided into 4 point scale and according to 28 creteria, indicators of standard were 3.72 and of criteria were 3.77 2) Inter - rater reliability (consentaneity score) of the tool by pearson correlation coefficient betwwen rates were r= .72, r= .75 and interreliabilities by single - facet crossed design were r= .96. 3) The alpha coeffecient relating to internal consistency was .7259 over 27 items of 28 criterias of developed tool. Through this study, I'm sure that the developed tool for the quality of patient care in chronic-renal failure patient will show the way of more improvement of the quality of nursing care and effective nursing intervention.

• Journal of Korean society of Dental Hygiene
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• v.4 no.2
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• pp.193-207
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• 2004

The aims of the study are as following : First, define and clarify the role and function of the dental hygienist. Second, based on thai definition, present an improved dental hygienist curriculum, improving their special competence. This study seeks to present a way for promoting role of dental hygienists as independent specialists, rather than as auxiliaries, contributing to better dental service in the process. The research was pursued by surveying by questionnaire those directly related to dental hygiene. They are 58 professors of dental hygiene, 164 dentists, 253 dental hygienists and 496 dental hygiene students, selected by the method of simple random sampling. Due to the small size of the sample, professors' group was analysed only through frequency and probabilities. For groups with larger samples(dentists, dental hygienists, dental hygiene students), methods of chi square(${\chi}^2$) tests, frequency analysis and one-way ANOVA were used in their analysis. Conclusions of the study are as following : First, role and function of the dental hygienist was defined and clarified. According to the analysis of the survey, main role of the dental hygienists as perceived by 62.9% of dentists was supporting treatments and managing patients and facility. This perception by dentists differs significantly to perception of other groups, which saw main role of dental hygienists as preventive dental treatment and dental hygiene education. Also, only 20.2% of dental hygienists perceived patients and facility management as their main role. This divergence of perception between groups weakens speciality competence of dental hygienists. To strengthen dental hygienists' speciality competence, preventive dental treatment and dental hygiene education must be defined as main role of dental hygienists. Furthermore, role of dental hygienists can be categorized into cooperative and auxiliary role. Second, in order to strengthen speciality competence of dental hygienists, their education must be augmented with curriculum emphasizing cooperative role. Specifically, courses on preventive dental treatment, dental hygiene education and dental X-ray photography must become compulsory, as well as becoming more comprehensive and organized. Also, training in schools and hospitals must be focused on those subjects. In addition, courses concerning auxiliary role must be incorporated into optional courses and more pedagogical courses are needed to widen students' career choices. Third, practical relevance of national dental hygienist certification examination must be heightened. In the survey, all groups gave negative response to questions concerning practical relevance of national dental hygienist certification test. Specifically, contents of the tests must be changed to test participants' competence in the cooperative area. Also, the test itself must be strengthened by adding practical examination to the certification scheme, as well as having more difficult examinations.

• Women's Health Nursing
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• v.5 no.2
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• pp.262-277
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• 1999

The purpose of this study is to define the effects of the roles played by the Doulas : one group educated on the conventional Lamaze method known to have effects on birth pang during delivery process and the other group educated both on Lamaze and therapeutic touch. On the various factors of delivery, and thereby, provide for some basic data to develop an effective nursing intervention to relieve women of their birth pang. 136 mothers who were hospitalized in a general hospital from June 13, 1998 to May 13, 1998 to May 13, 1999 to deliver their first babies were sampled to be divided into control group, test group I and test group II and thus be subject to interviews and observations. As for the tool of study, melzack's(1975) 'pain scale', McCaffery's(1972) and Mcrachlan's(1974) 'pain expression scales' and Spielberger's (1975) 'anxiety scale' were used. The preparatory educational programs consisted of 5week Lamaze method and therapeutic touch. The research, design was quasi-experimental, non equivalent, posttest only control group design. The collected data were processed using the SPSS/PC statistics software for frequencies, means and one-way Anova as well as Tukey HSD and Scheffe test as post hoc for individual comparison. Moreover, chi-square test was used to test the differences between groups, while Pearson's correlation coefficients were analyzed to determine the correlations between anxiety and variables. The findings are as follows ; 1. The birth pain of the mothers delivering first babies scored in a subjective and objective pain scale; 1) There was a significant difference of subjective birth pain at 8~10cm opening of cervix between control group and two test groups. 2) There was no significant difference of objective birth pain as per opening of cervex among three groups in terms of sweating, facial movement, bodily posture and vocal changes. 2. There was no significant difference of trait anxiety among three groups. however, there was a significant difference of state anxiety during labor process between control group and two test groups. On the other hand, all the three groups showed a significantly lower level of anxiety during labor process than when they were carried to the hospital. 3. There was a significant difference of the time of total and first-stage labor among three groups, while there was a significant but small difference of the time elapsed from 8~10cm cervix open to the full among three groups. 4. Two test groups showed a higher frequency of natural deliveries than the control group. 5. Two test groups were subject to these drugs than the control group. In conclusion, it was found that the test group I and II showed a shorter delivery time than the control group, a higher frequency of natural delivery and a lesser use of anodyne or epidural. In particular, this study is significant to develop a nursing intervention service or a therapeutic touch which the nursing administrators can apply to their hospitals in marketing programs.